What happens to your pet on the day of surgery? You drop them off, sign a form and leave. What are they experiencing? Here is how the day begins: First, we do a presurgical exam. We just recheck our last physical exam findings or examine the pet for the first time. If we hear a murmur or think the patient not a good candidate for anesthesia, we might cancel, reschedule or refer the surgery. Then we give an injection of 1-3 different medications depending on the particular case. This injection always includes a pain medication and often includes something to make the patient less anxious and another drug to keep the heart rate from going to low during surgery. This injection takes about 20 minutes to take effect. While we are waiting, we set up surgery and recheck the results of the preoperative blood work to again make sure they are good candidates for surgery. We then place an IV catheter. This is a very important step for the safety of your pet. If there is a reaction to anesthesia, the drugs to reverse the reaction are best given IV. We also use this catheter to give IV fluids during surgery which helps support blood pressure. Here is a picture of a dog with an IV catheter. The surgical site is clipped and we trim the nails now also. Always easier when they are sleepy from the first injection. Your pet is then taken into the surgery room and given another medication IV and this enables us to insert a tube into his or her trachea. The gas anesthesia is given through this tube. This is also another important step for safety. Anesthetics do depress breathing, so if your pet is not breathing often enough, we can breathe for them using this tube. We monitor oxygenation, blood pressure and heart rate during surgery. The amount of anesthetic agent used is constantly adjusted based on these monitored values. The person responsible for anesthesia watches your pet from the first injection until he or she is awake in their cage. Here is a picture of the machine we use to monitor anesthesia. The patient is also on a hot water blanket during surgery so they do not get too cold. Once we are sure all the parameters are normal and your pet is tolerating the anesthesia well, the surgical site is scrubbed and we are ready to start the procedure. Sometimes we feel as though the steps before surgery take longer than the procedure itself. But all these steps are important to lower the risk of surgery. Our patients wake up well and often seem back to themselves the next day.